Effectiveness and tolerance of respiratory rehabilitation in suspected pulmonary hypertension associated with chronic obstructive pulmonary disease

INTRODUCTION: Pulmonary hypertension (PH) is a frequent and serious complication of chronic obstructive pulmonary disease (COPD) with limited therapeutic options. The aim was to evaluate the effectiveness and tolerance of respiratory rehabilitation (RR) in COPD according to the echocardiographic probability of PH. METHODS: This was a retrospective, comparative observational study conducted between 2013 and 2023 in the University Hospital of Poitiers (France) and its associated rehabilitation center. All adult COPD patients with an echocardiographic assessment of the probability of PH and having undergone RR for at least 3 weeks were included. Patients with intermediate or high echocardiographic probability of PH, considered as suspected PHCOPD (s-PHCOPD) were compared with COPD patients with low probability of PH. The effectiveness of RR was assessed by the difference in the 6-minute walking distance (6MWD) between the beginning and the end of the RR course. Other criteria of RR effectiveness and tolerance were assessed. RESULTS: Fifty-nine patients were included (11 s-PHCOPD, 48 COPD without PH). The population was predominantly male with a median age of 65 [58-70] y.o, and all were smokers or ex-smokers. Both groups demonstrated significant improvement in 6MWD: 75 m [-24 to 121, p = 0.04] in the s-PHCOPD group and 33 m [6 to 63, p = 0.0001] in the COPD-without PH group with no significant difference in 6MWD improvement between groups (p = 0.3). There was no significant difference in the other criteria of effectiveness and tolerance between the two groups. CONCLUSION: RR was effective and well-tolerated in both s-PHCOPD and COPD-without PH patients. Prospective studies are needed to confirm these findings.